阿托伐他汀治疗老年人颈动脉粥样硬化斑块的临床观察.pdf

nullnullDSn2010,32(5):389null391JournalnullofnullShandongnullMedicalnullCollegeBRMv54%(山东医学高等专科学校附属医院,山东临沂276004)nullnullK1:null观察阿托伐他汀对老年人颈动脉粥样硬化斑块的治疗效果bZEnull将经超声检查发现存在颈动脉粥样斑块的116例患者随机分为治疗组和对照组,各58例b治疗组给予阿托伐他汀10mgnulld,顿服b对照组采用饮食控制或服用烟酸a非诺贝特等非他汀类药物b分别于入院时a治疗6a12个月动态监测两组患者的血脂水平,并进行颈动脉超声检查,评估颈动脉斑块积分b比较两组患者血脂和颈动脉斑块积分的变化bTnull所有116例患者完成了1年的治疗b血脂水平:治疗组与用药前相比,治疗6a12个月时TCaTGaLDL明显降低,HDL明显升高(P0.05)b6a12个月时治疗组TCaTGaLDL明显低于对照组,HDL明显高于对照组(P0.05)b颈动脉斑块积分:治疗组在6a12个月复诊时左a右侧颈动脉斑块积分与用药前相比有显著性降低(P0.05)b在6a12个月时治疗组左a右侧颈动脉斑块积分均低于对照组(P0.01)bnull阿托伐他汀除有良好的降脂作用外还有延缓甚至减轻动脉粥样硬化的作用b1oM:阿托伐他汀；颈动脉斑块；老年人nullnulldoi:10.3969nullj.issn.1674null0947.2010.05.030nullnullms|:R543.5nullnullnullnullDSM:AcI|:1674null0947(2010)05null0389null03nullTe:%(1969null),3,8E,1995M8ZMvD,D=,CVY5$T,X?V9bnulll:2010null04null03CLINICALOBSERVATIONONATORVASTATINTREATMENTINTHECAROTIDATHEROSCLEROSISPLAQUEXUMunullmin(TheAffiliatedHospitalofShandongmedicalCollege,Linyi,China,276004)Abstract:ObjectiveToobservetheeffectofatorvastatinoncarotidatherosclerosisiningerontalpatients.Methods116patientswithCarotidarteryplaqueweredividedintotwogroupsrandomly.58patientsweretreatnulledwithatorvastatin(10mg)pernightfor12months.58patientsweretreatedwithoutatorvastatin,andconsidnulleredascontrolgroup.Thefastingbloodlipidlevelandcarotidarteryplaquesscoreweremeasuredatthebeginnullningofthestudyathe6thmonthandthe12thmonthinbothgroups.ResultsAll116casespatientscompletetreatmentof12months.Thebloodlipidlevel:atthe6thand12thmonthsnulltreatment,comparedwiththebeginnullning,thelevelsofbloodTCaTGaLDLdecreasedsignificantly,HDLincreasedsignificantly(P0.05).Thecarotidarteryplaquesscore:thereisstanulltisticallysignificantdifferenceonthecarotidarteryplaquescorebetweentreatedanduntreatedgroupsatboth6thmonthand12thmonth.Inatorvastatinnulltreatedgroup,theplaquescoresofthepatientsweredecreased(P0.05).ConclusionThisstudysuggestnulledthatatorvastatincouldpossiblydelayevenlightentheprogressionofcarotidarteryatherosclerosisinadditiontotheirlipidnullloweringeffects.Keywords:Atorvastatin；Carotidarteryplaque；TheagednullnullvV1null2,R0?%?(LDLnullC)a(TG)a%?(TC),6%?(HDLnullC),H?EIvbV,BRYVTrV7Aa3h?hq3b4BRM(CAS)vTb1nullZE1.1null一般资料null2008M32009M1H2_v()ia/#0?116,385,o31；M-5273,(64.458.29)；8=V0b|sFvF,58,FHM-aYa5By1As(P0.05),V1b1.2null方法nullF:BR(:,A0zK/),10mgnulld,iGhf1FaFl0,S?,?Asi?5bvF:Jidv+dR0b116(2_b,h),%2D=v#vl,v(2a2a2),)v9vvlvs,0-sYB_bvsCASBSZE,zViV9:9v9b:J12hb|5mL,TCaTGaHDLLDLibH6a12hb1.3null统计学处理null9(nullxs)VU,FW(1t_,-1t_,q1null2_bSPSS10.0d9qd9sb2nullT2.1null血脂变化nullnV1bV1Vn,F0-FW1As；F:6a12HTCaTGaHDLaLDL0-M1As,TCaTGaLDLA,HDLA6；7vF-15d9ilb6a12H,FTCaTGaLDLaHDL1As(P0.05),FTCaTGaLDLAvF,HDLAvFbV1nullFvFM(nullxs,Cnullmmol!L-1)0-FvF6FvF12FvFTC5.270.875.230.714.520.77*#5.560.76*3.540.66*#5.751.03*TG2.090.692.051.121.510.70*#2.040.86*1.180.60*#2.031.16*HDL1.330.301.310.271.890.36*#1.300.26*2.260.33*#1.390.34*LDL3.310.803.160.682.440.66*#3.110.75*2.050.58*#3.100.90*nullF0-1:*P0.05；vF1:#P0.052.2null颈动脉斑块积分变化nullnV2bV2Vn,0-FPavs1d9il；F6a12HPavs0-M1A,vF5d9ilb6a12HFPavs(vFbV2nullFvFvsM(nullxs,Anullcm2)0-FvF6FvF12FvFP0.380.280.370.120.240.18*#0.340.140.140.14*#0.310.190.220.110.250.150.160.10*#0.230.220.110.07*#0.220.27nullF0-1:*P0.01；vF1:#P0.01390nullnullnullnullnullnullnullnullnullnullnullnullnullnullnullnullnullnullnullnullnullnull山东医学高等专科学校学报nullnullnullnullnullnullnullnullnullnullnullnullnullnullnullnullnull2010年32卷3null)Kn&d5%h,hM1#&va()bCAS&*NS,8V2_VT4&3g#hS4bV,CAS75%hM15null6,7A?3q.NF76,OvM17byCAS1oy,TCaTGaLDLnullC6,HDLnullC,T8b2004MReversal95=2NR0vY,LR0,3=vCh|,54GbsOqB2_4BVC#ZdS_ZEb=null(IMT)$ISb8V,IMTV$B2,ZE$V,2_$4HWwM7vFVbBR3null3Jnull=A(HMGnullcoA)4,50,VrTCaTGaLDL,6HDLbR0dT3:9fFTal?；=%5?,9=%8?；%M9#9=BT,V7CAS,h|v,P,h,h.N2bFnBRQ,FBR6vsC/tbvsMMi?3,vsMMbVFvsMBRdTb6?CF6BRZVCFr,4UBRT05bID1null,O2,0,.4BR$y0YJ.M75h,2008,10(4):250null253.2nullBLANCKDM,BAKKERnullARKEMARG,NAWROCKIJW.Anoverviewoftheclinicalsafetyprofileofatorvastatin(Lipitor),anewHMGnullCOAreductaseinhibitorJ.ArchivesofinternalMednullicine,1998,158(4):577null584.3nullSACCORL,BENJAMINEJ,BRODERICKJP,etal.AmericanHeartAssociationPreventionConferenceIV.PreventionandrehanullbilitationofstrokeriskfactorsJ.Stroke,1997,28(7):1507null1517.4null,.8V2_3hM1ZJ.5hZ,2003,24(4):306null308.5nullBUCCIARELLIP,SRAMEKA,REIBERJH,etal.Arterialintinullmanullmediathicknessanditsrelationshipwithcardiovasculardiseaseandatherosclerosis:apossiblecontributionofmediumsizedarternulliesJ.ThrombHaemost,2002,88(6):961null966.6nullv,F,.3.N1J.5BD,2006,15(5):441null445.7nullJANDERSS,SITZER,WENDTA,etal.expressionoftissuefacnulltorinhighnullgradecarotidarterystenosis.associationwithplaquedestabilizationJ.Stroke,2001,32(4):850null854.8nullCASSCELLSW,NAGHAVIM,WILLERSONJT.Vulnerableatheroscleroticplaque:amultifocaldiseaseJ.Circulation,2003,107(16):2072.9nullNISSENSE,TUZCUEM,SCHOENHAGENP,etal.Effectofintensivecomparedwithmoderatelipidlow